Johnson, Randall Richard

Johnson, Randall Richard is an individual health care provider with primary practice located at 102 E Kimberly Rd , Davenport IA 52806-5922. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Randall Richard can be contacted via phone (563) 386-1950.

Contact Information

Primary practice address
102 E Kimberly Rd Davenport IA 52806-5922
Fax: (563) 386-1021
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 02142 Iowa

Profile Details

NPI number 1780640391
LBN Legal business name Johnson, Randall Richard
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780640391 NPPES
Other 37150 BCBS
Other J01642089 BCBS

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